U N I V E R S I T Y O F I L L I N O I S A T U R B A N A - C H A M P A I G N

Department of Psychology College of Liberal Arts and Sciences 603 East Daniel Street Champaign, IL 61820

Informed Consent Please read this consent agreement carefully. You must be 18 years old or older to participate. Purpose of the research: Example: [To examine how people perceive and remember visual displays.]

What you will do in this study: Example: [You will view displays on a computer monitor and provide responses (in writing or by pressing keys on a computer keyboard). The displays may be arrays of letters, simple shapes or objects, photographs, or movies. You might also make predictions about how you or other people might do in performing a given task. While you are viewing the displays, we will use an eye tracker to measure where you are looking.]

Risks: There are no anticipated risks, beyond those encountered in daily life, associated with participating in this study. Additio nal risk info here, or leave blank if no anticipated risks. Example: [The task is attention demanding, so you might experience some fatigue as a result of participation.].

Compensation: The study will take under 50 minutes to complete. You will receive $ for participating in this study, or a lesser prorated amount if you withdraw before the session is completed. At the end of the study, you will receive an explanation of the study and the hypotheses. We hope that you will learn a little bit about how psychological research is conducted.

Voluntary Withdrawal: Your participation in this study is completely voluntary, and you may withdraw from the study at any time without penalty. You may skip over any questions or procedures, or you may withdraw by informing the research associate that you no longer wish to participate (no questions will be asked). Your decision to participate, decline, or withdraw participation will have no effect on your status at or relationship with the University of Illinois.

Confidentiality: Your participation in this study will remain confidential, and your identity will not be stored with your data. Your responses will be assigned a code number that is not linked to your name or other identifying information. All data and consent forms will be stored in a locked room. Results of this study may be presented at conferences and/or published in books, journals, and/or in the popular media.

Further information: If you have questions about this study, please contact , Department of Psychology, University of Illinois, Champaign, IL 61820. Email: ; phone: (217) .

Who to contact about your rights in this study: If you have any concerns about this study or your experience as a participant, you may contact the Institutional Review Board (IRB) at UIUC at (217) 333-2670 (collect calls will be accepted if you state you are a study participant); email: [email protected]

Agreement: The purpose and nature of this research have been sufficiently explained and I agree to participate in this study. I understand that I am free to withdraw at any time without incurring any penalty. I understand that I will receive a copy of this form to take with me.

Signature: ______Date: ______Name (print): ______IRB-approved template, 12-29-2005